The nurse is educating a client on the prevention of toxic shock syndrome (TSS). Which statement by the client indicates a lack of understanding?
- A. I need to change the tampon every 3 hours during the day.
- B. At night, I should use a feminine pad rather than a tampon.
- C. If I don't use tampons, I should not get TSS.
- D. I should wash my hands before inserting the tampon.
Correct Answer: A
Rationale: Tampons need to be changed every 3 to 6 hours to avoid infection by such organisms as Staphylococcus aureus. All of the other responses are correct: using feminine pads only, not using tampons at all, and washing hands before tampon insertion are all strategies to prevent TSS.
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A client has a recurrent Bartholin cyst. What is the nurse's priority action?
- A. Apply an ice pack to the area.
- B. Administer a prophylactic antibiotic.
- C. Support a fluid transfer to the liver analysis.
- D. Suggest moist heat such as a sitz bath.
Correct Answer: C
Rationale: A major cause of an obstructed duct forming a cyst is infection. The laboratory specimen is a priority since a culture is needed in order to prescribe sensitive antibiotics. Comfort measures can then be used, such as ice packs and moist heat.
A 55-year-old post-menopausal woman is assessed by the nurse with a history of dyspareunia, backache, pelvic pressure, urinary tract infections, and frequent urinary urgency. Which condition does the nurse suggest?
- A. Ovarian cyst
- B. Rectocele
- C. Cystocele
- D. Fibroid
Correct Answer: C
Rationale: Dyspareunia, backache, pelvic pressure, urinary tract infections, and urinary urgency are all symptoms of a cystocele, a protrusion of the bladder through the vaginal wall. Ovarian cysts are rare after menopause, a rectocele is associated with constipation, hemorrhoids, and local impaction. Fibroids are associated with heavy bleeding.
A client has undergone a vaginal hysterectomy with a bilateral salpingo-oophorectomy. She is concerned about a loss of libido. What intervention by the nurse would be best?
- A. Suggest increasing vitamins and supplements daily.
- B. Discuss the value of a balanced diet and exercise.
- C. Reinforce that weight gain may be inevitable.
- D. Teach that estrogen cream inserted vaginally may help.
Correct Answer: D
Rationale: Use of vaginal estrogen cream and gentle dilation can help with vaginal changes and loss of libido. Weight gain and masculinization are misperceptions after a vaginal hysterectomy. Vitamins, supplements, a balanced diet, and exercise are helpful for healthy living, but are not necessarily going to increase libido.
The nurse is teaching a client who is undergoing brachytherapy about what to immediately report to her health care provider. Which signs and symptoms would be included in this teaching? (Select all that apply.)
- A. Constipation for 3 days
- B. Severe diarrhea
- C. Abdominal pain
- D. Visible blood in the urine
- E. Heavy vaginal bleeding
Correct Answer: C,D,E
Rationale: Health teaching for a client having brachytherapy should emphasize reporting abdominal pain, visible blood in the urine, and heavy vaginal bleeding. Severe diarrhea, urethral burning, extreme fatigue, and a fever over 100°F should also be reported. Constipation for 3 days is not typically a critical symptom to report immediately in this context.
A client who had a hysterectomy has a 200-mg dose of ciprofloxacin (Cipro) ordered to infuse in 30 minutes. At what rate should the nurse infuse the medication if the pharmacy provides 200 mg in a 100-mL bag of normal saline? (Record your answer using a whole number) mL/hr
- A. 200 mL/hr
- B. 100 mL/hr
- C. 150 mL/hr
- D. 250 mL/hr
Correct Answer: A
Rationale: To calculate the infusion rate: The pharmacy provides 200 mg in a 100-mL bag, to be infused over 30 minutes. Infusion rate (mL/hr) = Total volume (mL) ÷ Time (hr). Here, 100 mL ÷ 0.5 hr = 200 mL/hr.
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